S.F. sues Nevada for giving mental patients one-way bus tickets

SACRAMENTO, Calif. — The state of Nevada and its primary psychiatric hospital “intentionally and wrongfully” foisted the cost of caring for indigent mentally ill people onto California cities and counties by issuing patients bus tickets out of town without making proper arrangements for their care, a lawsuit filed Tuesday in San Francisco charges.

San Francisco City Attorney Dennis Herrera filed the class-action lawsuit against Nevada, Rawson-Neal Psychiatric Hospital in Las Vegas and state mental-health administrators, seeking reimbursement for the care of indigent patients he said the system “dumped” onto California in an effort to save money.

“What the defendants have been doing for years is horribly wrong on two levels,” Herrera said in a written statement announcing the lawsuit. “It cruelly victimizes a defenseless population, and punishes jurisdictions for providing health and human services that others won’t provide.”

In addition to unspecified financial damages, the suit asks for a permanent injunction preventing Nevada from dispatching psychiatric patients to California unless they are residents of the destination city or county, are being sent to family members who have agreed to care for them, or are being sent to a medical facility where arrangements have been made for their treatment.

Mary Woods, spokeswoman for the Nevada Department of Health and Human Services, said Tuesday afternoon that her agency would have no immediate comment on the suit.

The action follows a formal demand Herrera issued last month to Nevada officials.

He said he planned to take legal action within weeks unless the state reimbursed San Francisco $500,000 for care of patients he maintains have been improperly bused to the city since 2008.

Herrera said an investigation by his office had identified 24 patients who had been bused to San Francisco over the past five years, 20 of whom Herrera said required emergency treatment upon arrival.

Nevada’s attorney general responded this week with a letter arguing that San Francisco had offered insufficient evidence to justify its claim.

Records gathered by state health officials and given to Herrera “demonstrate that the policies are appropriate and that only proper discharges were made,” reads the letter, sent Monday and signed by Chief Deputy Attorney General Linda Anderson.

Nevada’s mental-health system has been in the spotlight for months, after a Sacramento Bee report published earlier this year that found Rawson-Neal had bused 1,500 mentally ill patients out of Southern Nevada from July 2008 through early March 2013. About 500 were given one-way tickets to California.

The Bee undertook its investigation after one of those patients, James Flavy Coy Brown, turned up suicidal and confused at a Sacramento homeless-services complex after a 15-hour bus ride from Las Vegas to the capital city. Brown said he knew no one in Sacramento and that Rawson-Neal doctors advised him to dial 911 once he arrived in the city.

Nevada health officials have acknowledged that they erred in shipping Brown to Sacramento without any arrangements for care. But they contend his case was an exception and that the vast majority of patients bused from Rawson-Neal had family or treatment waiting for them on the other end of their journeys.